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Comments Family history may become outdated Advanced age does not exclude familial incidence of ESRD Familial screening may have identified relatives with CKD leading to medical care Hypertension, obesity

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Familial incidence of ESRD (after exclusion of ADPKD and known hereditary disorders) Even for ESRD caused by different etiologic factors Most studies from the US: may not apply to Europe –High proportion of African Americans –High prevalence of morbid obesity Background-3

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33% of physicians do not know that there is an increased incidence of ESRD in relatives of ESRD patients

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AIMS To study the prevalence of familial ESRD and CKD among ESRD patients in Spain To identify and offer advice to families with CKD or ESRD

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Secondary aims To identify risk factors for familial ESRD in Spain To study the prevalence of occult CKD (sCr, albuminuria) among relatives of ESRD patients in Spain: early treatment To identify new familial nephropathies (not diagnosed or not described) Identify genetic risk factors for progression to ESRD

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Work plan Pilot study Nationwide study A) Transversal epidemiological study Interview of ESRD patients Study of occult CKD in first degree relatives B) Identification, study and follow-up of families with 2 or more members with CKD or ESRD Contact family members Instruct them to contact their physicians: physical exam plus basic analytical studies Offer specialized follow-up

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Conclusions Pilot study –A significant proportion of Spanish ESRD patients have relatives with CKD or ESRD. –While ESRD and diabetes were clearly identified, there was less knowledge about family history of hypertension and CKD –The second interview generally did not improve the quality of the information –Does the increase prevalence of familial ESRD in females reflect better knowledge of family matters? General –A more extensive study is warranted –European figures may be lower than in the US –Study of occult CKD in relatives of ESRD patients may uncover patients who will benefit from early treatment